The diaphragm is a dome-shaped bowl made of thin, flexible rubber that sits over the cervix.
The diaphragm keeps sperm from entering the uterus by blocking the cervix. For added protection, spermicide is put into the bowl of the diaphragm and along its edges before inserting the diaphragm high into the vagina so it covers the cervix.
The diaphragm is inserted up to 6 hours before having sex. More spermicide must be used each time a girl has sex while wearing the diaphragm. Additional spermicide should also be used if a girl is going to have sex more than 3 hours after she inserted the diaphragm. After sex, the diaphragm must be left in for at least 6 hours, but no longer than 24 hours. The diaphragm can be removed by placing a finger into the vagina to pull it out.
Each time the diaphragm is removed, it must be washed (with mild soap and water), rinsed, and air dried, then stored in its case. It should not be dusted with baby powder and should never be used with oil-based lubricants such as mineral oil, petroleum jelly, or baby oil. These substances can cause the rubber to become brittle and crack. Other vaginal creams, such as yeast medicines, can also damage the rubber.
A diaphragm should be replaced at least every 2 years. It should be examined regularly for holes or weak spots, and replaced as needed.
Over the course of 1 year, 16 out of 100 typical couples who rely on the diaphragm with spermicide to prevent pregnancy will have an accidental pregnancy. In general, how well each type of birth control method works depends on a lot of things. In the case of a diaphragm, some of the most important things to be sure of are that it fits correctly, that is used every time a couple has sexual intercourse, and that spermicide is used appropriately.
Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.
Most women who use a diaphragm have no problems with it. The side effects that some women have include:
Girls who can take responsibility for sex in advance use diaphragms. If a girl chooses to use a diaphragm, she must also always have a supply of spermicide.
The diaphragm isn't good for anyone who is uncomfortable or uneasy with the thought of reaching into her vagina. And it may not be a good choice for girls with certain medical conditions, such as frequent urinary tract infections (UTIs). The diaphragm should not be used when a girl has her period.
A doctor must fit a girl with a diaphragm. During a pelvic exam the doctor will measure a girl's vagina and then determine which size of diaphragm is right for her. The doctor or nurse will then teach her how to insert and remove the diaphragm. A diaphragm that's inserted incorrectly or does not fit properly can result in pregnancy.
During the annual exam, the doctor will check that the diaphragm still fits correctly. The diaphragm may not fit correctly if a girl has gained or lost 10 pounds, had a baby, had an abortion, or was fitted when she was a virgin and she is now having sex. If any of these things have changed since her last exam, a girl should see her doctor to have the fit of the diaphragm checked rather than waiting until her annual exam.
A diaphragm usually costs about $15 to $75. It should be replaced every 2 years. There is also the cost of the doctor's visit and a fitting fee. Many health insurance plans cover these costs and family planning clinics (such as Planned Parenthood) charge much less. In addition, the cost of spermicide is about $0.50 to $1.50 per use.
Reviewed by: Mary L. Gavin, MD
Date reviewed: August 2013
|Planned Parenthood Info for Teens This site from the Planned Parenthood Federation of America has information on relationships and sexual health for teens.|
|National Campaign to Prevent Teen and Unplanned Pregnancy This site provides teen pregnancy facts, resources, and prevention tips.|
|Planned Parenthood Federation of America Planned Parenthood offers information on sexually transmitted diseases, birth control methods, and other issues of sexual health.|
|American College of Obstetricians and Gynecologists (ACOG) This site offers information on numerous health issues. The women's health section includes readings on pregnancy, labor, delivery, postpartum care, breast health, menopause, contraception, and more.|
|GYT - Get Yourself Talking and Get Yourself Tested This media campaign designed to get young people to talk with their health care providers and partners about the importance of getting tested for sexually transmitted diseases.|
|Irregular Periods Wondering whether it's normal to have irregular periods? Get the facts about this common problem.|
|Abstinence Abstinence is the only form of birth control that is 100% effective in preventing pregnancy. Abstinence also protects people against STDs.|
|About Birth Control Before you consider having sex, you need to know how to protect yourself. Read this article to get the basics on birth control.|
|Talking to Your Partner About Condoms Some people - even those who are having sex - are embarrassed by the topic of condoms. Here are some tips for talking about condoms with your partner.|
|Birth Control Methods: How Well Do They Work? Some birth control methods work better than others. This chart compares how well different birth control methods work.|
|Cervical Cap Before you consider having sex, you need to know how to protect yourself. Read this article about the cervical cap to find out if it's right for you and how well it works.|
|What Can I Expect From the Gynecologist? Find out what the experts have to say.|
|Gyn Checkups Girls should get their first gynecological checkup between ages 13 and 15. Find out what happens during a yearly gyn visit -- and why most girls don't get internal exams.|
|When Is it Time to Start Seeing a Gynecologist? Find out what the experts have to say.|
|About Sexually Transmitted Diseases (STDs) You've probably heard lots of discouraging news about sexually transmitted diseases. The good news is that STDs can be prevented. Find out how to protect yourself.|
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